Alcohol counseling reflects higher quality of primary care

BACKGROUND: Some primary care physicians do not conduct alcohol screening because they assume their patients do not want to discuss alcohol use. OBJECTIVES: To assess whether (1) alcohol counseling can improve patient-perceived quality of primary care, and (2) higher quality of primary care is associated with subsequent decreased alcohol consumption. DESIGN: A prospective cohort study. SUBJECTS: Two hundred eighty-eight patients in an academic primary care practice who had unhealthy alcohol use. MEASUREMENTS: The outcome was quality of care received [measured with the communication, whole-person knowledge, and trust scales of the Primary Care Assessment Survey (PCAS)]. The secondary outcome was drinking risky amounts in the past 30 days (measured with the Timeline Followback method). RESULTS: Alcohol counseling was significantly associated with higher quality of primary care in the areas of communication (adjusted mean PCAS scale scores: 85 vs. 76) and whole-person knowledge (67 vs. 59). The quality of primary care was not associated with drinking risky amounts 6 months later. CONCLUSIONS: Although quality of primary care may not necessarily affect drinking, brief counseling for unhealthy alcohol use may enhance the quality of primary care.